Overview
Fertility refers to the natural ability to conceive a pregnancy. For pregnancy to happen, an egg must be released, sperm must reach the egg, fertilization must occur, and the fertilized egg must implant in the uterus. Many people conceive without difficulty, while others need time, testing, or treatment. Fertility is influenced by age, timing of sex, medical conditions, and reproductive health in both partners.
Causes and Risk Factors
Fertility can be affected by problems with ovulation, low sperm count or movement, blocked fallopian tubes, endometriosis, infections, hormonal disorders, and some genetic conditions. Age is an important factor, especially for egg number and egg quality over time. Smoking, heavy alcohol use, certain drugs, untreated sexually transmitted infections, exposure to toxins, and major weight loss or gain can also play a role. Some medicines and cancer treatments may affect fertility as well.
Who Is Affected
Anyone who wants to have a child can have fertility questions or concerns. Fertility problems can affect women, men, and couples of any background. People with irregular periods, known reproductive conditions, past pelvic infections, prior surgery, or a history of undescended testes may face added challenges. Fertility needs also include people planning pregnancy later in life and those who want information before medical treatment that may affect reproduction.
Prevention
Not all fertility problems can be prevented, but some risks can be lowered. Protecting against sexually transmitted infections, avoiding smoking and drug misuse, limiting alcohol, managing chronic health conditions, and seeking care for missed or very irregular periods may help. If possible, discussing fertility goals before chemotherapy, radiation, or reproductive organ surgery can be important. Vaccination and routine health care can also support overall reproductive health.
Diagnosis and Tests
Healthcare professionals may ask about menstrual cycles, timing of sex, pregnancies, past infections, surgery, medicines, and lifestyle factors. Testing may include ovulation assessment, hormone blood tests, pelvic ultrasound, imaging of the uterus and fallopian tubes, and semen analysis. Sometimes more than one factor is found. Testing is usually guided by age, history, and how long pregnancy has been attempted.
Treatment Categories
Treatment depends on the cause and may include cycle tracking, treatment for ovulation problems, procedures to address blocked tubes or other structural issues, or treatment related to sperm factors. Assisted reproductive technologies, such as intrauterine insemination or in vitro fertilization, may be discussed in some cases. Treatment plans vary by medical history, age, local availability, cost, and personal values. A healthcare professional can explain benefits, limits, and possible risks of each option.
Diet and Lifestyle
General health supports reproductive health. Eating a balanced diet, being physically active, getting enough sleep, and managing stress may help overall well-being while trying to conceive. Avoiding tobacco, limiting alcohol, and discussing supplements or over-the-counter products with a clinician may be useful because some products can affect fertility or pregnancy. Heat exposure, anabolic steroids, and some workplace chemicals may affect sperm in some people.
When to Seek Medical Care
Consider speaking with a healthcare professional if pregnancy has not happened after a period of regular unprotected sex, or earlier if there are known fertility concerns. Seek care sooner for very irregular or absent periods, severe pelvic pain, repeated pregnancy loss, past pelvic inflammatory disease, history of testicular problems, or prior cancer treatment. Medical advice can also help with pre-pregnancy planning, including review of medicines, vaccines, and chronic conditions.
Questions to Ask a Healthcare Professional
You may want to ask what might be affecting fertility, what tests are recommended first, and whether both partners should be evaluated. Other helpful questions include how age or medical conditions may affect chances of pregnancy, what treatment categories are available, and what costs or timelines to expect. If future fertility may be at risk, ask whether fertility preservation should be discussed.